Extreme home-birthing, alone and unassisted

The Rich family: Krissy, Isabella, 6, Lilly, 1, Elijah, Arianna, 8, Shelby, 11, and Jasrael, 5, Rich, in their Fremont, Calif. home, on Sunday, Jan. 26, 2014. Rich is expecting her sixth child in July. She has all girls and is expecting a sixth girl. She is choosing the freebirth method that allows the woman to experience birth without painkillers, doulas or midwifes. She will give birth in the birthing tub with only the assistance of her husband, Elijah. (Jim Stevens/Bay Area News Group)

Krissy Rich had been in active labor for five hours on the floor of her Fremont bathroom when her daughter Jasrael descended. To ease the pressure, Rich reached her fingernail inside and popped her amniotic sac to break her water.

"That was probably the most empowering thing I've ever done," says Rich, a 34-year-old mother of five. "I had to have faith in myself and surrender that control at the end."

Many pregnant women in our culture shudder at the thought: being alone in the house or on the road when your water breaks with no one to calm or guide you through labor, no trained specialist to help you bring your baby safely into this world.

Krissy Rich, in a inflatable birthing tub in the bathroom of her Fremont, Calif. home, on Sunday, Jan. 26, 2014. (Jim Stevens/Bay Area News Group)

But for a small group of women such as Rich, solitude is what they want. Freebirth, or unassisted birth, as they call it, is by definition a planned process. It ranges from having an attendant, such as a doula, present for emotional support to being alone, laboring and delivering your baby without assistance. While on the rise, out-of-hospital births account for a small percentage of total births in the United States, about 2 percent, according to a 2010 CDC trend report. Freebirth is a tiny part of that, and women who choose it do so for a variety of reasons, from financial to religious.

For the three Bay Area women who shared their freebirth stories, the choice was ethically and emotionally driven.

"Giving birth this way is an old knowledge," says Maryn Leister, a certified midwife who in 2007 started Indiebirth, a newsletter and now a website and support network that provides free podcasts and other educational materials to women who want to birth alone or with autonomy, even if they hire a midwife. "Birth is a physiological process, and more women are starting to understand the way it works without interference.

Craving solitude

Navarre Miya's decision to do a freebirth was shaped by her experience as an assistant midwife. After attending 60 births and giving birth to her first child, Scarlet, under a midwife's care, she witnessed how a midwife can positively assist a laboring woman. However, she also discovered that for a self-proclaimed introvert like her, the presence of anyone, even a licensed midwife, fundamentally changes the experience.

"It changes the way a woman feels as far as being witnessed and her ability to be comfortable and let go," says Miya, 35. "I had an extreme desire to be not witnessed."

For the birth of her second daughter, Miya wanted to be alone. The morning her contractions started, she reassured her husband, Cliff, that she was fine and told him to go to work. She would call him when the time was right.

The Miya family Navarre, left, Ivy, 8 months, Scarlett, 3, and Cliff photographed at their Oakland, Calif., home on Friday, Jan. 24, 2014. Navarre is trained as a midwife and birthed her second child, Ivy, alone at home. Out of the home birth and natural birth movements has sprung unassisted childbirth. (Dan Honda/Bay Area News Group)

At 10 a.m., she sent her mother and Scarlet to the library. Then she called her midwife, who had handled her prenatal care, asking her to linger at the coffee shop down the street, in case of an emergency.

As soon as everyone left, her labor "kicked into high gear."

"It was really intense, really fast," recalls Miya, who texted her husband to come home. Her surges were so strong, she called out to the silence, "Are you kidding me?!"

In between contractions, she felt calm and more concerned with prepping the birth tub. Looking back on her 45 minutes of active labor, Miya says she never felt panic or fear. She also never felt the need to push. "I really felt that my body and baby were working perfectly together, and I just needed to be able to get out of the way and let it all happen."

At 10:30 a.m., she called Cliff to find out where he was. She called her mother at 10:40 a.m. to see if Scarlet wanted to watch her sister being born. If so, they'd need to head back to the house immediately.

At 10:43 a.m., Cliff swung open the front door of the house to his wife's shrill cries. He washed his hands, knelt down in front of his wife, who was on the floor in the sun-dappled bathroom, and caught Ivy, his baby girl. She slipped out at 10:45 a.m.

"It was such a sweet, beautiful and unbelievably empowering experience," Navarre Miya says. "And to have that special bubble time right after, just the three of us, it was so natural and normal and I was thinking, 'Oh, God, I wish everyone could experience this.' "

Cara Judea Alhadeff and her son, Zazu Chock Alhadeff-Racker, 2, photographed in their Oakland, Calif. home, Thursday, Jan. 23, 2014. Alhadeff is an advocate for unassisted childbirth, i.e., no involving a physician or midwife, and she gave birth to Zazu at home, mostly unassisted. (D. Ross Cameron/Bay Area News Group)

'Perfectly capable'

Yoga instructor Cara Judea Alhadeff gave birth to her son, Zazu, exactly as she had visualized it: In the tiny, plant-filled bathroom of her Oakland home on April 8, 2011, her 40th birthday and his expected due date.

Alhadeff, an artist, writer and lecturer, hired a midwife for her prenatal care but accepted no interventions. No blood tests. No ultrasounds.

"I felt perfectly capable of birthing a healthy child," she says. "I felt any intervention was superfluous and often inaccurate and that hypermedicalized technologies like ultrasounds strip us of our innate knowledge of our bodies."

Her eight-hour labor was spent traveling from the toilet to the bedroom and back. Alhadeff vomited. She had trouble breathing. However, with the aid of her boyfriend, Kent, she tried to focus on her contractions, timing them until they lasted 45 seconds and hoping her midwife would arrive in time.

"I would enter a bizarrely deep, restful state in the midst of the extreme sensations, and then I would come out and need immediately to count numbers, any numbers to feel safe," she recalls.

Alhadeff's midwife was unable to come, so their backup doula showed up just as Alhadeff's two final screams tore through the air.

"Get on your hands and knees," the doula, Jenna, instructed. Suddenly, Alhadeff could breathe. "Everything snapped into alignment," she recalls. As Kent straddled her, he saw Zazu's purple head emerge, then retract. The cord was wrapped around the baby's neck, and one of his shoulders was caught behind her pubic bone.

It was a good thing Jenna was there. Even though she had never delivered a baby before, she reached into Alhadeff, unwrapped the cord and dislodged the baby's shoulder. Moments later, she passed him to Alhadeff.

"It was like riding a huge wave, like coming back home and almost remembering something ancient," she says. "Instead of pushing and rushing, I'd rather be present and witness the rapture of birth."

It's potential emergencies such as this case of shoulder dystocia that make doctors wary of the freebirth approach. Complications during childbirth are rare, but they are still significant, Walnut Creek obstetrician Timothy Leach says.

"I wouldn't recommend it (freebirth), because the risk is too great," says Leach, medical director of obstetrics and gynecology at John Muir Medical Center. "I just can't know how to handle those emergencies if I'm not there. It's in those rare, unpredicted moments that you don't want to catch yourself alone."

'She slips right out'

After giving birth to three healthy girls at home with the aid of a midwife, Krissy Rich, of Fremont, was drawn to freebirth because of her Mormon faith. She also was wary of anesthesia after witnessing a family member's addiction to prescription drugs.

"Their whole focus (at the hospital) is, 'Let's get you that baby,' " says Rich, who is 34 and works for an essential oils company. "For me, it's about the process. And I knew I could do it."

To prepare for those first three births, she and her husband, Elijah, read "Husband-Coached Childbirth" (Bantam, 2008) by Robert Bradley and studied hypnosis for childbirth.

For the birth of her third child, Isabella, Krissy created a mantra, "She slips right out," and repeated it throughout labor. She wrote calming words, like "peace" and "open," on pieces of paper strewed about the bathroom. When Isabella crowned, the midwife pushed her through Krissy's legs. "I was able to just pull her out," she says.

Krissy's fourth child, Jasrael, was her first unassisted birth. She studied more. She borrowed emergency equipment, including an oxygen mask, from a friend, a licensed midwife. She prayed. She spoke to the baby, encouraging her that it was safe to come out.

"I was creating a spiritual connection between us," Krissy recalls.

For the fifth baby, Lillian, the couple hired a midwife, because Krissy realized she missed "having that feminine energy and someone to handle the post-birth logistics."

In the end, the midwife was running late, and Krissy did it on her own in a blowup tub in her bedroom, with Elijah's coaching.

"I was grateful she wasn't there," she says. "I was able to make the sounds I needed to make and be vulnerable and open."

When women tell Krissy they could never give birth this way, she tells them that they can.

"We don't prepare our bodies at all in this culture," she says. "From day one, I'm doing yoga and hip-opening and using antibacterial essential oils for pregnancy and getting my vitamins. I think in our culture, we want to have this sterile experience and remove ourselves from the intenseness of birth. There's a sense of trying to suppress the feelings."

Resources

"Unassisted Chilbirth" (Bergin & Garvey): Laura Kaplan Shanley's 1993 book was reissued in 2012 on hardcover. Her website by the same name provides a hub for women to talk about freebirth plans, join forums and read birth stories. www.unassistedchildbirth.com.Indiebirth Association: Certified professional midwife Maryn Leister's private health membership group that offers free as well as paid podcasts and other educational materials about holistic pregnancy care and unassisted childbirth. www.indiebirth.com. Paala Secor blog: Oakland mother of two who blogs about breast-feeding, homebirth, and parenting and is considering home birth for her third child, which is due this month. http://doublethink.us.com/paala.